Varicocele is far more common on the left side than the right. What is the principal anatomical reason for this left-sided predominance?
- A The left testicular vein drains into the left renal vein at a right angle ✓
- B The left testicular vein drains into the inferior vena cava at an acute angle
- C The left testicular vein is shorter than the right
- D The left cremasteric plexus lacks competent valves
Correct answer: A. The left testicular vein drains into the left renal vein at a right angle
Explanation
The left internal spermatic (testicular) vein enters the left renal vein almost at a right angle, creating a longer hydrostatic column and higher resistance to flow, whereas the right vein joins the inferior vena cava obliquely. This anatomy also explains why a sudden left varicocele in an older man raises suspicion of left renal cell carcinoma invading the renal vein. Valve incompetence contributes but occurs bilaterally and does not explain the sidedness.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.